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147 ' <br />Good L=I.., creat Service. <br />..umNaN M r.w.. <br />202400253 <br />NE Sec of State - Robert B. Evnen <br />Filing Document #: 2401000542-0 Pages: 1 <br />Debtor Name: ANNABELLA L MASON <br />Filing Date and Time: 01/18/2024 10:14 AM <br />Notice of State Tax Lien <br />This Notice of State Tax Lien is issued by the Nebraska <br />Department of Revenue for unpaid taxes administered by the Tax <br />Commissioner. Taxes, including penalties, interest, and costs, <br />which are shown below, ere due from the taxpayer and remain <br />unpaid after demand.These taxes ere a lien for all property located <br />in the county and rights to property owned by the taxpayer or <br />acquired before the expiration of this lien -This lion will expire and <br />become unenforceable 10 years after the date of recording if no <br />continuation statement is recorded on or prior to the expiration of <br />the previous lien or continuation statement. <br />PLEASE OO NOT WRITE IN THIS SPACE <br />Nebraska ID Number <br />94396302 <br />Federal tO Number <br />NO FEIN <br />Lice Serial Number <br />12456801 <br />Lien Freed With: <br />® Register of Deeds ['County Cleric <br />Social Security Number <br />XXX -XX -6531 <br />SpouseY Sodas Security Number <br />NO SPOUSE SSN <br />Dale of lien <br />January 9, 2024 <br />Irian Twit, <br />Qrxmeasd <br />CENrrdy <br />HALL <br />1,f Original 0Cordkwation <br />us ateos Hants ttwre t_ocation <br />Taxpayer Name and Mailing Address <br />ANNABELLA L MASON <br />3111 COLLEGE ST APT 96 <br />GRAND ISLAND NE 68803 <br />Tax Program <br />Tax Period <br />Date of <br />Assessment <br />Tax <br />Penalty <br />interest <br />Costs <br />Total Due <br />Individual <br />2022 <br />05/05/2023 <br />$1,338.00 <br />$66.90 <br />$49.30 <br />$1,454.20 <br />Total <br />$1,454.20 <br />sign <br />here <br />I certify that the Nebraska Department of Fiewmue hes complied with dee laws of the State of Nebraska In determining the amount shown to be due. <br />and Mat the taxpayer has tailed to pay the amount due atter demand. This Notice of State Tax Lien is an.tectwa lien and serves to continue tat priority of <br />the State's Interest In the elected property of the taxpayer. <br />Preparers Signature <br />teed Signs <br />Revenue Aaent 01/0912024 (402)471-5788 <br />Tide Date Awe Number <br />Revenue Supervisor 01/09/2024 <br />rme Data <br />4.4944971 Rev. 5.2011 Supaeedas 4-015.4471 Rem 99013 <br />